Precision anesthesia brings good news again - 95-year-old man was discharged from hospital within 24 hours after laparoscopic surgery

With the advent of the aging population, anesthesiologists are facing more and more senior patients. In particular, the development of minimally invasive surgery has enabled more and more seniors to bravely choose surgical treatment to improve their quality of life in their later years.

Recently, Rob Zhang, who is over 95 years old, heard that Zhongshan People's Hospital can perform minimally invasive surgery to treat hernias with Surgical instruments. As long as two holes are punched in the body, he can cure his long-standing disease. Rob was diagnosed with a left-sided hernia by an outpatient specialist.

On the first day of admission, the old man's physical indicators showed no contraindications for surgery, and an elective laparoscopic surgery was immediately arranged for the next day. Although laparoscopic surgery is minimally invasive, it is generally completed under Endotracheal Tube intubation and general anesthesia. The elderly are generally accompanied by underlying diseases, and the functions of various organs have declined, especially the part of the brain where general anesthetics are affected. The brains of the elderly are also called "fragile brains." General anesthesia may cause postoperative delirium in the elderly. Cognitive dysfunction, etc.

During anesthesia, an Anesthesia consumables are used to control the breathing of patients, which may damage the patient's own respiratory function and cause some pulmonary complications. The cardiovascular stress response caused by tracheal tube intubation may also cause some people with underlying diseases. to adverse consequences.

Zhan Haibo, deputy chief physician of the Department of Anesthesiology, received the notification of the operation and immediately visited the patient before the operation. He found that although the patient had a history of hypertension and diabetes for many years, he took medication regularly and his blood pressure and blood sugar were well controlled. The electrocardiogram showed high left ventricular voltage and occasional high voltage. The room was early, and other examination results and laboratory indicators were basically normal. The elderly can usually take care of themselves, their cardiopulmonary function is basically normal, and they can basically tolerate anesthesia surgery. After communicating with the patient and their family members and weighing the benefits and risks of giving the elderly man general anesthesia, the elderly man, who had suffered from hernia for more than ten years, boldly chose minimally invasive surgery under general anesthesia.

After entering the operating room at eight o'clock the next morning, Dr. Zhan chatted with the old man while giving him anesthesia according to the established individualized anesthesia plan. Routine monitoring plus nacrotrend EEG consciousness monitoring was performed, and propofol plasma target-controlled infusion was given for induction. After successful tracheal intubation, propofol and remifentanil were maintained under intravenous anesthesia. During anesthesia, protective pulmonary ventilation was provided, goal-directed fluid infusion and vasoactive drugs were used to regulate circulation, and the circulating nurse took measures to maintain warmth.

Dr. Zhang, the surgeon, performed the laparoscopic surgery in an orderly manner, completed the laparoscopic exploration cleanly, and performed the transabdominal preperitoneal left inguinal hernia tension-free repair (TAPP). After the operation, in order to optimize the postoperative analgesic effect, local infiltration of ropivacaine was given to the incision.

Since the patient was given personalized and precise anesthesia, the old man was awake and had his tracheal tube removed ten minutes after the operation. After half an hour of observation, if there is no abnormality, the patient will be sent back to the ward.

The old man was awake and quiet after returning to the ward, and no anesthesia complications were found. On the morning after the operation, the anesthesiologist went to the ward for follow-up. The old man was in good spirits and happily told the anesthesiologist that he could be discharged this morning. It turned out that Director Zhang had long referred to the management standards for day surgery and believed that the old man had no discomfort after the operation, all indicators were basically normal, and he could be discharged from the hospital within 24 hours after the operation.

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